PD41-08 CHRONIC KIDNEY DISEASE AND END-STAGE RENAL DISEASE AFTER RADICAL OR PARTIAL NEPHRECTOMY FOR T1A RENAL CELL CARCINOMA: A POPULATION-BASED STUDY
Bibliographic record
Abstract
You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (PD41)1 Apr 2019PD41-08 CHRONIC KIDNEY DISEASE AND END-STAGE RENAL DISEASE AFTER RADICAL OR PARTIAL NEPHRECTOMY FOR T1A RENAL CELL CARCINOMA: A POPULATION-BASED STUDY Madhur Nayan*, Olli Saarela, Keith Lawson, Lisa Martin, Maria Komisarenko, and Antonio Finelli Madhur Nayan*Madhur Nayan* More articles by this author , Olli SaarelaOlli Saarela More articles by this author , Keith LawsonKeith Lawson More articles by this author , Lisa MartinLisa Martin More articles by this author , Maria KomisarenkoMaria Komisarenko More articles by this author , and Antonio FinelliAntonio Finelli More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556552.01352.65AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Surgery remains the mainstay of treatment for localized renal cell carcinoma (RCC). However, there remains uncertainty whether partial nephrectomy is associated with a reduced risk of developing chronic kidney disease or end-stage renal disease compared to radical nephrectomy. Therefore, the objective of this study was to compare renal outcomes in patients undergoing partial or radical nephrectomy for T1a RCC. METHODS: We used administrative databases, several of which have been validated, to perform a population-based study of patients in Ontario, Canada, undergoing a partial or radical nephrectomy for T1a RCC between 1994 and 2014. We excluded patients with more than one nephrectomy or a previous history of chronic kidney disease, diabetes, or hypertension. The outcomes of interest were diagnosis of chronic kidney disease and end-stage renal disease requiring renal replacement therapy, defined as receipt of chronic dialysis or renal transplant. We used Cox proportional hazard models to evaluate the association between partial vs. radical nephrectomy and these outcomes. RESULTS: We identified 1967 patients that met inclusion criteria, of which 893 (45.5%) underwent partial nephrectomy. Patients undergoing partial nephrectomy were more likely to be younger, have a lower Charlson score, have smaller tumour sizes, and undergo surgery in more recent years. With a median follow-up in those without death of 7.6 years (interquartile range 4.3 - 12.9), 238 and 15 patients developed chronic kidney disease and end-stage renal disease, respectively. Multivariable Cox proportional hazard models found that partial nephrectomy was independently associated with a significantly reduced risk of chronic kidney disease (hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.10 to 0.25). On univariate analysis, partial nephrectomy was not significantly associated with receipt of renal replacement therapy (HR 0.26, 95% CI 0.06 to 1.17). CONCLUSIONS: Our population-based study comparing partial vs. radical nephrectomy for T1a renal cell carcinoma found that partial nephrectomy was associated with significantly reduced risk of chronic kidney disease. However, the need for renal replacement therapy occurred infrequently and there was no significant association with type of surgery. Source of Funding: none Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e747-e748 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Madhur Nayan* More articles by this author Olli Saarela More articles by this author Keith Lawson More articles by this author Lisa Martin More articles by this author Maria Komisarenko More articles by this author Antonio Finelli More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".